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PEDIATRIC COLONOSCOPY: Instruction for Bowel Preparation

PEDIATRIC COLONOSCOPY: INSTRUCTION FOR BOWEL PREPARATION 


Proper bowel preparation prior to colonoscopy is VERY IMPORTANT. If your child’s bowels are not cleaned out well enough, the procedure may have to be canceled or rescheduled. If you are unable to follow the instructions or have any questions, it is better to call your physician to clarify your doubts.


  1. Give the child a liquid or semisolid diet (water, milk, dal, fruit juice, soup or broth, khichri, dahlia) from 2 days prior to the procedure. Try to avoid solid food.


  1. On the day before the procedure:

    1. Prepare PEGLEC solution [Polyethylene glycol with electrolytes for oral solution (137.15g); mix the whole packet with 2 liters of drinking water; Additional flavor (pineapple or orange) available within the packet can be added for taste]

    2. Administer the PEGLEC solution from 3 pm onwards; Give 250 ml orally every hour (for infants: 30ml/kg/hour); it will result in frequent defecation with loose stools; Continue giving it till stool becomes clear and watery. 

    3. Mild side effects like nausea, abdominal pain or colic can occur which usually don’t need any intervention or stoppage of therapy. 

    4. If the child is having persistent vomiting or there is a history of failed procedure because of poor bowel preparation, the child might need to be admitted to daycare one day prior for bowel preparation with NG (naso-gastric) tube. 


On the day of Colonoscopy:

Keep the NPO in the morning. [If your child is taking prescribed medications, they can usually be continued with just a sip of water]

Time: Try to reach well ON TIME. The admission procedure begins at 8 am in the morning. 

Venue: AIIMS main building (Ward block), 5th Floor, C5/Daycare/Endoscopy room (you can ask security guard for directions)


After Arrival:

  1. Report checking as per institutional protocol  [Covid testing: RT-PCR or CBNAAT of child and attendant; CBC, Viral markers for first timer (HBsAg, Anti-HCV, Anti-HIV I & II)] 

  2. Informed consent form to be signed.

  3. Admission slip to be made from Railway counter (deposit 60/-)

  4. IV cannulation

  5. Dress changing: disposable gown will be provided from the procedure room. 

  6. Loose (Lactulose) enema will be given per-rectally. 

  7. Child will be taken to the endoscopy room for sedation and procedure. Vital signs will be monitored throughout the procedure. The procedure usually takes 20-30 min to complete after which the child will be shifted out of the endoscopy room for observation and monitoring. 



WISH YOU A HAPPY VISIT; STAY SAFE

Few extra points: 

Ideally it should:

  1. Clear the colon completely

  2. Create no gross discomfort

  3. Result no fluid/ electrolyte imbalance

  4. Not cause alteration of colonic mucosa

  5. Be Inexpensive 

  6. Take shorter duration to show adequate efficacy




PEGLEC (Polyethylene glycol with electrolytes for oral solution) [137.15g]

Laxative:  as per mode of action, they are divided into osmotic and stimulant laxatives.

Osmotic agents: magnesium citrate, sodium phosphate, PEG (Polyethylene glycol) and PEG with electrolytes

Stimulant laxatives:  Bisacodyl and Senna.

Efficacy measured by:

colon cleanliness index (Ottawa bowel preparation scale)




Author info: Dr Sabyasachi, MD, Pediatrics (AIIMS, New Delhi)


































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